Provider Demographics
NPI:1952716300
Name:NUNEZ, LEONEL SR (DO)
Entity Type:Individual
Prefix:
First Name:LEONEL
Middle Name:
Last Name:NUNEZ
Suffix:SR
Gender:M
Credentials:DO
Other - Prefix:MR
Other - First Name:LEONEL
Other - Middle Name:
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OPTICIAN
Mailing Address - Street 1:1920 RALPH JANES PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4062
Mailing Address - Country:US
Mailing Address - Phone:915-633-9763
Mailing Address - Fax:915-633-9764
Practice Address - Street 1:2921 GEORGE DIETER DR STE D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-2945
Practice Address - Country:US
Practice Address - Phone:915-633-9763
Practice Address - Fax:915-633-9764
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic